Gluten intake and risk of type 2 diabetes in three large prospective cohort studies of US men and women.

Diabetologia
Authors
Keywords
Abstract

AIMS/HYPOTHESIS: We investigated the association between gluten intake and long-term type 2 diabetes risk among Americans.

METHODS: We followed women from the Nurses' Health Study (NHS, n = 71,602, 1984-2012) and NHS II (n = 88,604, 1991-2013) and men from the Health Professionals Follow-Up Study (HPFS, n = 41,908, 1986-2012). Gluten intake was estimated using a validated food frequency questionnaire every 2-4 years. Incident type 2 diabetes was defined as self-reported physician-diagnosed diabetes confirmed using a supplementary questionnaire.

RESULT: Gluten intake was strongly correlated with intakes of carbohydrate components, especially refined grains, starch and cereal fibre (Spearman correlation coefficients >0.6). During 4.24 million years of follow-up, 15,947 people were confirmed to have type 2 diabetes. After multivariate adjustment, pooled HRs and 95% CIs for type 2 diabetes, from low to high gluten quintiles, were (p  0.001): 1 (reference); 0.89 (0.85, 0.93); 0.84 (0.80, 0.88); 0.78 (0.74, 0.82) and 0.80 (0.76, 0.84). The association was slightly weakened after further adjusting for cereal fibre, with pooled HRs (95% CIs) of (p  0.001): 1 (reference); 0.91 (0.87, 0.96); 0.88 (0.83, 0.93); 0.83 (0.78, 0.88) and 0.87 (0.81, 0.93). Dose-response analysis supported a largely linear inverse relationship between gluten intake up to 12 g/day and type 2 diabetes. The association between gluten intake and type 2 diabetes was stronger when intake of added bran was also higher (p = 0.02).

CONCLUSIONS/INTERPRETATION: Gluten intake is inversely associated with type 2 diabetes risk among largely healthy US men and women. Limiting gluten in the diet is associated with lower intake of cereal fibre and possibly other beneficial nutrients that contribute to good health.

Year of Publication
2018
Journal
Diabetologia
Volume
61
Issue
10
Pages
2164-2173
Date Published
2018 10
ISSN
1432-0428
DOI
10.1007/s00125-018-4697-9
PubMed ID
30074058
PubMed Central ID
PMC6182774
Links
Grant list
CA167552 / NH / NIH HHS / United States
HL035464 / NH / NIH HHS / United States
ES022981 / NH / NIH HHS / United States
R01 ES021372 / ES / NIEHS NIH HHS / United States
CA176726 / NH / NIH HHS / United States
R01 DK058845 / DK / NIDDK NIH HHS / United States
R01 HL035464 / HL / NHLBI NIH HHS / United States
U01 CA167552 / CA / NCI NIH HHS / United States
R01 ES022981 / ES / NIEHS NIH HHS / United States
CA186107 / NH / NIH HHS / United States
U01 CA176726 / CA / NCI NIH HHS / United States
UM1 CA186107 / CA / NCI NIH HHS / United States
UM1 CA176726 / CA / NCI NIH HHS / United States
K24 DK098311 / DK / NIDDK NIH HHS / United States
ES021372 / NH / NIH HHS / United States
UM1 CA167552 / CA / NCI NIH HHS / United States
DK058845 / NH / NIH HHS / United States